Although, immunization coverage for Penta 3 (DTP3) in Ghana stands at 87.9 percent (Source: MICS 2012), the 11th-highest rate of all sub-Saharan African countries, there are still pockets of districts with low immunization coverage in Ghana. Ghana Coalition of NGOs in Health (GCNH) in 2011 was alarmed by the situation where in spite of the high immunisation coverage there still exist a good number of communities with very low immunisation coverage and hence high rate of infant mortality. GCNH therefore initiated a partnership with the Government of Ghana (GoG) through the Ghana Health Service (GHS) and with funding support from GAVI to support the efforts of the state to increase immunization services and ensure access and equity to immunisation services in marginalized and hard to reach communities.
With the GAVI Type B Window Support to CSOs in 2011, members of the GCNH were able to significantly increase demand for immunization services in 100 most deprived and hard to reach communities in the Central and Volta regions which contributed to increasing immunization coverage in those districts in Ghana. For instance, between 2008 – 2010 Penta 3 coverage in most of the communities in the Volta Region stood at 70 per cent, however the coverage increase to between 85 – 95 per cent after the collaboration of CSOs and the GHS in that region. The collaboration involved CSOs engaging in community mobilisation and education for the GHS, joint celebration of the National Immunisation Days (NID), joint monitoring of immunisation activities in deprived communities and also CSOs provide information about the supply chain bottlenecks to the GHS. Members of the GCNH were very instrumental during the introduction of the Rubella and Pneumococcal vaccines in 2013.
The Power of effective collaboration
GCNH relationship with Ministry of Health (MOH), GHS and Development Partners has significantly improved due to the role GCNH plays in the health systems of Ghana. Since the introduction of the composite budgeting in Ghana, GCNH members have successfully influenced the district health budget through evidence-based advocacy as well as engaged to ensure that resources are made available for outreach programmes in deprived and hard-to-reach communities. GCNH has also contributed to health policy outcomes through the participation of members in health forums and made recommendations to and suggestions at Inter-agency Coordinating Committee (ICC) and Health System Coordination Committee (HSCC) at the national, either monthly, quarterly, half-yearly and or yearly. At the sub-national levels, our members have participated actively in GHS review meetings volunteering information that will help in local policy formulation.
The work of the GCNH contributed to expanding immunization coverage in the two regions where GCNH members worked. Best practices such as strengthening community systems and structures, male involvement in the demand for immunization and quality health services and other innovations were used to support over 100 communities to increase immunization coverage to over 90 per cent.
GCNH has been instrumental in the six rights of immunisation, especially the right place. Through GCNH’s efforts immunisation services are now getting to places where before CSOs involvement were treated as hard to reach communities. Based on the above achievements, GCNH has proposed to scale up immunization to at least 45 districts (5 districts per region) with Penta 3 coverage below the national average of 92.1 per cent with the 2014-2017 HSS support. This will enable CSOs to contribute to achieving the national EPI goals and GAVI’s strategic goal 2 of “strengthening the capacity of integrated health systems to deliver immunization”.
Innovations: Community register
The GCNH with the support given to its members has been able to develop an innovative tool called “Community Register” which has now been accepted by GHS/EPI. It is being used now for documenting immunization data of children under 5 years and also defaulter tracking, the registers provide an opportunity for community volunteers to identify defaulting mothers and trace them to their homes and ensure they bring their children for immunisation.
Ghana Coalition of NGOs in Health (GCNH) is an umbrella Civil Society Organisation (CSO) supporting its members and coordinating the activities of all registered member-NGOs/CBOs or FBOs in the health sector in Ghana.. GCNH currently has an active membership of over 400 registered NGOs/CBOs in all the 10 regions of Ghana and in almost every district. GCNH involvement in supporting the provision of immunization services, strengthening of health systems and paying attention to underserved/marginalised communities has helped to improve service delivery in some deprived districts and communities in Ghana and has strengthened the relationship with Government since 2009.